scholarly journals Intracameral antibiotics for prophylaxis of postoperative endophthalmitis in Australia: A review—Comment

2020 ◽  
Vol 48 (6) ◽  
pp. 854-855
Author(s):  
Gursimrat K. Bhullar ◽  
Andrew H. Hurley ◽  
Christine Tan ◽  
Penelope J. Allen
Keyword(s):  
Postoperative Endophthalmitis ◽  
Review Comment ◽  
Intracameral Antibiotics

scholarly journals Comparative analysis of the safety and efficacy of intracameral cefuroxime, moxifloxacin and vancomycin at the end of cataract surgery: a meta-analysis

2018 ◽  
Vol 102 (9) ◽  
pp. 1268-1276 ◽  
Author(s):  
Randy C Bowen ◽  
Andrew Xingyu Zhou ◽  
Sailaja Bondalapati ◽  
Thomas W Lawyer ◽  
Karisa B Snow ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Meta Analysis ◽  
Safety Analysis ◽  
Incidence Rates ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Postoperative Endophthalmitis ◽  
Topical Antibiotics ◽  
Intracameral Antibiotics ◽  
Practice Methods

BackgroundCurrent practice methods are unclear as to the most safe and effective prophylactic pharmacotherapy and method of delivery to reduce postoperative endophthalmitis occurrence.MethodsA systematic review and meta-analysis using Meta-analysis of Observational Studies in Epidemiology guidelines was performed to compare the efficacy of intracameral cefuroxime, moxifloxacin and vancomycin in preventing postphacoemulsification cataract surgery endophthalmitis. A safety analysis of intracameral antibiotics was concurrently performed.Data sourcesBIOSIS Previews, CINAHL, ClinicalTrials.gov, Cochrane Library, Dissertations & Theses, EMBASE, PubMed, ScienceDirect and Scopus were searched from inception to January 2017. Data were pooled using a random effects model. All articles were individually reviewed and data were extracted by two independent reviewers. Funnel plot, risk of bias and quality of evidence analyses were performed.ResultsSeventeen studies with over 900 000 eyes were included, which favoured the use of intracameral antibiotics at the end of cataract surgery (OR 0.20; 95% CI 0.13 to 0.32; P<0.00001). The average weighted postoperative endophthalmitis incidence rates with intracameral cefuroxime, moxifloxacin and vancomycin were 0.0332%, 0.0153% and 0.0106%, respectively. Secondary analyses showed no difference in efficacy between intracameral plus topical antibiotics versus intracameral alone (P>0.3). Most studies had low to moderate risk of bias. The safety analysis showed minimal toxicity for moxifloxacin. Dosing errors led to the majority of toxicities with cefuroxime. Although rare, vancomycin was associated with toxic retinal events.ConclusionIntracameral cefuroxime and moxifloxacin reduced endophthalmitis rates compared with controls with minimal or no toxicity events at standard doses. Additionally, intracameral antibiotics alone may be as effective as intracameral plus topical antibiotics.

Incidence of postoperative endophthalmitis from 1990 to 2009 using povidone–iodine but no intracameral antibiotics at a single academic institution

2015 ◽  
Vol 41 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Martin M. Nentwich ◽  
Christopher N. Ta ◽  
Thomas C. Kreutzer ◽  
Bing Li ◽  
Fabian Schwarzbach ◽  
...  
Keyword(s):  
Povidone Iodine ◽  
Academic Institution ◽  
Postoperative Endophthalmitis ◽  
Intracameral Antibiotics
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